To determine the prevalence of presbyopia and associated risk factors among Bangladeshi recipients of elderly social safety net payments who were not currently using mobile financial services (MFS) and demonstrated numeracy, dexterity and cognitive prerequisites for smartphone use during eligibility screening for the Transforming Households with Refraction and Innovative Financial Technology (THRIFT) trial. Accessing these payments requires use of online banking, as with a smartphone.

Cross-sectional analysis of trial eligibility screening data.

Community-based screening conducted in two rural subdistricts in Kurigram District, Bangladesh.

Among 13 944 Old Age Allowance and Widows’ Allowance (WA) beneficiaries screened, 953 met trial eligibility criteria, including passing a smartphone readiness assessment and completing near vision examinations.

Presbyopia, defined as binocular presenting near visual acuity of N6.3 or worse, correctable to at least N5 with near vision glasses and with distance vision of ≥6/12 in both eyes.

Among 953 participants (mean age 61.4±7.2 years, 62.6% women), presbyopia prevalence was 62.6% (95% CI 59.5 to 65.7). Presbyopia was significantly positively associated with female gender (adjusted prevalence ratio (APR)=1.19, 95% CI 1.02 to 1.41) and receiving WA (APR=1.20, 95% CI 1.04 to 1.38) in multivariable analyses.

This study highlights a substantial burden of uncorrected presbyopia among a prescreened, randomised control trial-eligible subgroup of social safety net beneficiaries in rural Bangladesh, who were not currently using MFS but demonstrated cognitive and functional capacity to use mobile phones, potentially hampering their ability to carry out online banking. Delivery of reading glasses may improve digital financial access and facilitate broader financial inclusion, a hypothesis currently being tested in the parent THRIFT trial.

NCT05510687.

Patients in intensive care units (ICUs) and their families face existential physical, psychosocial and spiritual distress. Integrating palliative care (PC) into ICU care may benefit patients, relatives and ICU clinicians. Prior PC studies have shown a reduction in ICU length of stay (LOS) and distressing symptoms without altering overall mortality. A shorter ICU LOS may alleviate the burden for patients and relatives and help optimise the use of limited intensive care resources. PC in the ICU, however, remains underused, partly due to limited access and knowledge of ICU clinicians. Also, robust data regarding the effectiveness and cost-effectiveness of PC treatment in the ICU are scarce. We established the ‘enhancing palliative care in ICUs’ (EPIC) study to implement a system-based harmonised practice model across European ICUs. The aim is to investigate if early integration of PC via telemedicine, clinician education and bedside tools is effective and cost-effective, ultimately benefiting patients, relatives and ICU clinicians.

This multicentre, controlled, cluster-randomised, non-blinded stepped-wedge design trial with crossover phase aims to recruit around 2,000 patients from five European countries. All adult patients admitted to participating ICUs—with an ICU LOS exceeding 72 hours, where cancer is not the primary cause of critical illness, and who are not expected to die within the next 24 hours—are screened for the need for specialised PC based on the attending physician’s judgement. This judgement is triggered by the presence of one or more of the following: (1) significant disagreement among ICU team members and/or relatives about the appropriateness of current ICU treatment, (2) considerations of limiting life-sustaining therapy or (3) the anticipation that a specialised PC consultation may benefit the patient, their relatives or the ICU team. Patients identified as needing specialised PC and their relatives are then enrolled after obtaining written informed consent.

The complex intervention consists of (a) a blended-learning programme to foster knowledge and attitude about PC among ICU clinicians, (b) bedside tools, including a checklist to identify patients in need of PC and a factsheet and (c) standardised telemedical consultations from trained EPIC interventionists. Patient and relative follow-up is conducted 3 months post-ICU discharge. Outcomes include clinical measures (including ICU LOS (primary outcome), severity of critical illness, invasive treatments and health-related quality of life), economic endpoints (resource use, costs, cost–consequence situation, cost-effectiveness), ICU clinician burnout and distress, and patient and family perception about the quality of symptom management, care and communication. Endpoint analyses will employ generalised linear mixed models, accounting for the clustered data structure and stepped wedge design.

EPIC complies with the Declaration of Helsinki and has been approved by all local ethics committees. A decision-making structure is established to ensure trial procedures are carried out according to Good Clinical Practice. Study findings will be published in peer-reviewed journals and communicated to participants, healthcare professionals and the public. Sets of anonymised study data will be made available following Findable, Accessible, Interoperable, and Reusable principles.

NCT06605079.

To assess prevalence and associated factors of adverse childhood experiences (ACEs) among patients with severe mood disorders (SMDs).

An institution-based cross-sectional study.

Gedeo Zone Public Hospitals, Southern Ethiopia.

374 patients with SMDs were recruited using a systematic sampling technique.

The data were collected using an interview-administered questionnaire and medical chart review. The outcome variable was assessed using the ACEs questionnaire. Data were coded and entered into Epi Data 3.1 and analysed using SPSS V.26. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with ACEs. The presence of an association was examined using an adjusted OR (AOR) with a 95% CI. Variables with P-values less than 0.05 were considered a statistically significant association.

The overall prevalence of ACEs among patients with SMDs was 51.6% (95% CI 49.2 to 53.9), and the prevalence of ACEs among patients with severe bipolar disorders and depressive disorders was 14.7% with (95% CI 46.8 to 52.4) and 36.9% with (95% CI 46.7 to 55.8), respectively. Having low socioeconomic status (SES) (AOR=2.04 (95% CI 1.40 to 3.45), poor social support (AOR=2.43 (95% CI 1.74 to 4.17)), low resilient coping strategies (AOR=1.48 (95% CI 1.21 to 2.83)) and severity of depressive symptoms (AOR=3.82 (95% CI 2.89 to 6.00)) were significantly associated with ACEs.

This study reveals a high prevalence of ACEs among patients with SMDs, with more than half of the participants reporting at least one ACE. Low SES, low resilient coping strategies and poor social support were factors significantly associated with ACEs, and severe depressive symptoms were significantly associated with ACEs. Therefore, these findings underscore the importance of early screening and appropriate intervention for SMDs and ACEs, and providing more holistic mental healthcare for SMDs and ACEs, improving access to education and economic support, strengthening social support networks, enhancing resilience-building programmes and integrating routine ACEs assessments into mental health evaluations could potentially contribute to improved clinical outcomes and support long-term recovery.

Not applicable

The gig economy is a promising arena to reduce unemployment and provide other benefits such as the opportunity to earn supplemental income. Like all other forms of work, the gig space also presents occupational health issues for those working in it. This proposed review is aimed at identifying and describing the common occupational health outcomes reported within this workforce; second, to examine the risk factors that contribute to the development of these health issues; and third, to assess the interventions and support systems currently in place to promote the occupational health of gig workers.

A systematic review will be undertaken according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (2009). A search from 2015 to 2025 will be conducted on four global databases (Web of Science, SCOPUS, Academic Source Complete and Business Source Complete). Only records in English, full text and peer-reviewed journal articles will be included. Book chapters, thesis, reports and systematic reviews will be excluded. The Joanna Briggs Institute Critical Appraisal Tools will be used to assess the methodological rigour of various studies prior to inclusion for the final analysis. The extracted data will be synthesised using a narrative synthesis approach, integrating findings from both quantitative and qualitative studies.

This research is exempt from ethics approval because the work will be carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal.

CRD420250654059.

Frailty in people living with HIV is a critical concern due to its significant impact on health, functional capacity and overall quality of life. This scoping review aims to synthesise comprehensive information on frailty in this population, establish foundational evidence and identify research gaps, with particular emphasis on the need for interventions targeting multidimensional frailty among community-dwelling people living with HIV.

This scoping review adheres to the Joanna Briggs Institute guidelines and the framework developed by Arksey and O’Malley. The research questions will focus on frailty among community-dwelling people living with HIV. The literature search will encompass four databases: MEDLINE, Embase, CINAHL and the Cochrane Library, covering studies published from 1 January 2001 to 30 June 2025. Only peer-reviewed articles published in English will be included. Both quantitative and qualitative studies will be considered. The inclusion criteria will be guided by the population-conceptual-context (PCC) framework. The findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.

Ethical approval is not required as this study involves an analysis of previously published literature. The findings will inform the development of interventions for frailty in people living with HIV and will be disseminated through academic conferences, peer-reviewed publications and expert seminars.